ANEMIA IN PREGNANCY

PRESENTER : AKSHAY JADHAV

ROLL NO : 06
UNIV REG NO : 06M1607
 SUBHEADINGS:
• DEFINITION
• CAUSES
• ETIOLOGY
 DEFINITION
• Anemia
• Anemia in pregnancy
 ANEMIA
• from Ancient Greek “anaimia”, meaning "lack of blood“
• DEFINITION:
• Anemia is a state which is characterised by:
- decrease in normal number of red blood cells (RBCs)
- less than the normal quantity of hemoglobin in the blood
- decreased oxygen-binding ability of each hemoglobin
molecule (due to deformity or lack in numerical development)
- appropriate for that age and sex
• Acc to WHO:
• For Adult male <13g/dl
• For Adult female  <12g/dl (non-pregnant)
 ANEMIA IN PREGNANCY
• DEFINITION:
• ACCORDING TO CDC
ANEMIA IN PREGNANCY IS DEFINED AS:
- Hb LESS THAN 11g/dl IN FIRST AND THIRD
TRIMESTER AND
- Hb OF LESS THAN 10.5g/dl IN SECOND
TRIMESTER
• ACCORDING TO WHO
ANEMIA IN PREGNANCY IS DEFINED AS Hb LESS
THAN 11g/dl.
• The degree of anemia is graded according to
the Hemoglobin (Hb) level as follows:
• Moderate 7.0 – 10.9 g/dl
• Severe 4.0 – 6.9 g/dl
• Very severe < 4.0 g/dl
Mean hemoglobin concentrations ( ---- ) and 5th and 95th (o----o)percentiles for healthy
pregnant women taking iron supplements. ( Data from Centre for Disease Control, 1989a)
 CLASSIFICATION OF ANEMIA

• MORPHOLOGICAL CLASSIFICATION

• ETIOLOGICAL CLASSIFICATION

• CLINICAL CLASSIFICATION
 MORPHOLOGICAL CLASSIFICATION

 MICROCYTIC HYPOCHROMIC
o IRON DEFICIENCY ANEMIA
o SIDEROBLASTIC ANEMIA
o THALASSEMIA
o ANEMIA DUE TO CHRONIC DISORDERS

• NORMOCYTIC NORMOCHROMIC
o ACUTE BLOOD LOSS
o HEMOLYTIC ANEMIA
o BONE MARROW FAILURE
o ANEMIA OF CHRONIC DISORDERS
• MACROCYTIC NORMOCHROMIC
o DEFICIENCY OF VIT B 12
o DEFICIENCY OF FOLIC ACID
 ETIOLOGICAL CLASSIFICATION
Pathological
Physiological
 Pathological
NUTRITIONAL ANEMIA

• IRON DEFICIENCY
• FOLIC ACID DEFICIENCY
• VIT B 12 DEFICIENCY
• PROTIEN DEFICIENCY
ANEMIA DUE TO BLOOD LOSS

ACUTE BLOOD LOSS

• ANTE PARTUM HEMORRHAGE
• ABORTION
• HYDATIDIFORM MOLE
• ECTOPIC PREGNANCY

CHRONIC BLOOD LOSS

• BLEEDING PILES
• HOOKWORM
• MENORRHAGIA
ANEMIA DUE TO CHRONIC INFECTION
• MALARIA
• TUBERCULOSIS
• DYSENTRY
• REPEATED UTI
• PYELONEPHRITIS

ANEMIA DUE TO CHRONIC DISEASES

• RENAL DISEASE
• LIVER DISEASE
• NEOPLASM
• INFLAMMATORY BOWEL DISEASE
• SLE
• GRANULOMATOUS DISEASES
ANEMIA DUE TO BONE MARROW
INSUFFICIENCY

• HYPOPLASIA
• APLASIA (APLASTIC ANEMIA)

HEREDITARY CAUSES OF ANEMIA

• THALASSEMIAS
• SICKLE CELL HEMOGLOBINOPATHIES
• OTHER HEMOGLOBINOPATHIES
HEMOLYTIC ANEMIA

ACQUIRED
• AUTOIMMUNE HEMOLYTIC ANEMIA
• DRUG INDUCED
• PREGNANCY INDUCED
• PAROXYSMAL NOCTURNAL HEMOGLOBINURIA

INHERITED
• HEREDITARY SPEROCYTOSIS
• RED CELL ENZYME DEFICIENCIES
PREGNANCY ANEMIA
 Physiological

• Concept
• Occurs due to:
- disproportionate increase in plasma volume,
RBC volume, and hemoglobin mass during
pregnancy (hemodilution)
- there is marked demand of extra iron during
pregnancy(esp. in second halfnegative iron
balance)
• Similar to iron deficiency anemia
 Criteria for Physiological Anemia:

The lower limit of physiological anemia during

the second half of pregnancy should fulfill the
following hematological values:
1.Hb- 10gm%
2.RBC- 3.2 million/ cumm
3.PCV- 30%
4.Peripheral smear showingnormal morphology
of the RBC with central pallor
 CLINICAL CLASSIFICATION
• SYMPTOMATIC

• ASYMPTOMATIC
• MATERNAL MORTALITY 20 %
• INCIDENCE OF ANEMIA

40 -80 % ---- IN DEVELOPING COUNTRIES

10 – 20 % ---- IN DEVELOPED COUNTRIES
 Causes of increased prevalence (in
tropics)
• Faulty dietetic habit
• Faulty absorption mechanism
• Iron loss:
- more iron loss through sweat
- Repeat pregnancies at short intervals
- Excessive blood loss during menstruation
- Hookworm infestation
- Chronic malaria, bleeding piles & dysentry
 Factors that lead to development of
anemia in pregnancy
• Increased demands of iron
• Diminished intake of iron
• Disturbed metabolism
• Pre-pregnant health status
• Excess demand
- multiple pregnancy
- Women with rapidly recurring pregnancy
- The demand of iron which accompanies the natural
growth before the age of 21
?????
 Y OU
A N K
TH
FOR UR PATIENT HEARING!!!
PATIENT HEARING!!!!!?????